Mary Ticknor, DNAP

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

CR001191 Issued in SD

Practice address

910 E 20TH St
Sioux Falls, SD 57105-1012

Phone

(605) 334-6730

NPI assigned

Jul 5, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mary Santella Former name

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sioux Falls Specialty Hospital, LLPGroup PAC ID 3173510898, 53 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sioux Falls Specialty Hospital Hospital, Sioux Falls, SD, CCN 430090

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sioux Falls Specialty Hospital, LLP

  • Special Hospital
  • Sioux Falls, SD
  • NPI 1316946809
  Medicare reassignment Care Compare group NPD
• Sioux Falls Specialty Hospital, LLP

  dba Sioux Falls Urgent Care

  • Primary Care Clinic/Center
  • Sioux Falls, SD
  • NPI 1447780796
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sioux Falls Specialty Hospital, LLP

  • Special Hospital
  • Sioux Falls, SD
  • NPI 1316946809
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1881430163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S TORREY PINE LN",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571107649",
            "telephone_number": "605-929-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 E 20TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051012",
            "telephone_number": "605-334-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICKNOR",
        "first_name": "MARY",
        "credential": "DNAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-05",
        "last_updated": "2024-07-05",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SD",
            "license": "CR001191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "SANTELLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• THVC Services of SD, P.C.
• Rachel Thyberg
• Noel Dexter Luis Tiangco, M.D.
• Christopher Steven Tibbetts, PAC
• Shelly Rae Tibke, CNP
• Carla Tiedeman
• Jerel E Tieszen, M.D.
• Nicholas Lee Tieszen, RN
• Jeremy John Tietgen, D.C.
• Heather Joy Tietjen, NP

• Certified Registered Nurse Anesthetist in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Certified Registered Nurse Anesthetist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.